Provider Demographics
NPI:1427558329
Name:JONES, AMANDA NICHOLAS (CFNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:NICHOLAS
Last Name:JONES
Suffix:
Gender:F
Credentials:CFNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17791 US HIGHWAY 45
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:MS
Mailing Address - Zip Code:39341-4518
Mailing Address - Country:US
Mailing Address - Phone:662-574-1093
Mailing Address - Fax:
Practice Address - Street 1:78 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:MS
Practice Address - Zip Code:39341-2490
Practice Address - Country:US
Practice Address - Phone:662-738-4424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11000746363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11000746OtherAPRN
MS879657OtherRN
MS902530OtherAPRN